Abstract

Abstract Introduction The use of recreational substances in a sexual context (sex-linked substance use) is common among young adults, with up to a third indicating that that they used alcohol, cannabis, or both during their recent partnered sexual activity (Willis et al., 2021; Herbenick et al., 2018). Sex-linked substance use (SLSU) is associated with a variety of positive and negative clinical outcomes including increased sexual pleasure, but also greater risk for condomless sex. Expectations of how one will behave and feel during sex while under the influence have been shown to predict SLSU habits. Contextual factors like relationship status may contribute to these expectancies, with studies finding that young women who are casually dating have more positive sexual expectancies of alcohol compared to women who are not dating or are in a long-term relationship (e.g., Patrick et al., 2014; Pedersen et al., 2009). Given the relationship between SLSU, relationship status, and sexual expectancies, it is likely that other contextual factors of a relationship, like partnered sexual desire, may play a role in sexual outcomes of women’s substance use. However, little is known about how partnered sexual desire is related to either substance sex-related expectancies in college-aged women. Objective To investigate how relationship status and partnered sexual desire is related to differences in alcohol and drug sexual expectancies and SLSU. Methods We surveyed 512 women (mean age 20.09, SD = 1.56) in the Midwestern US. Participants completed the Brief Comprehensive Expectancies of Alcohol and Drug scales, assessing their alcohol and drug expectancies, including sex-related expectancies (e.g., “to be a better lover” and to “enjoy sex more”); the Sexual Desire Inventory, assessing partnered and solitary sexual desire; and reported their relationship status, frequency of SLSU, and demographics. Using independent sample t-tests and multivariate general linear models, we examined how relationship status and partnered & solitary sexual desire interacted to predict differences in alcohol and drug sex-related expectancies and SLSU. Results Contrary to previous research findings, relationship status alone was not related to either alcohol or drug sex-related expectancies or SLSU. However, there was a marginally significant interaction between relationship status and sexual expectancies in predicting women’s SLSU. Specifically, the association between more positive sexual expectancies and higher frequency of SLSU was relatively stronger in partnered women. Moreover, regardless of relationship status, women who reported higher levels of partner desire reported more positive sexual alcohol and drug expectancies. Additionally, women who reported more positive sexual alcohol and drug expectancies reported more frequent SLSU. In contrast, solitary sexual desire was not a significant predictor of either substance-related sexual expectancies. Conclusions Our results indicate that partnership and partnered desire may interact with alcohol and drug sexual expectancies to predict women’s SLSU. These findings question the predominant assumption that women’s use of substances in sexual settings is primarily in casual sexual contexts and points to the need for targeted interventions to address the functions of SLSU in the context of women’s long-term relationships. Clinically, these findings reinforce the value of including our patient’s partner when addressing sexual dysfunction secondary to substance use. Disclosure No

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